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Peripheral Vascular DiseasesMSOT_ICNCT05373927

Calf Muscle Perfusion in Patients With Intermittent Claudication by Non-invasive MSOT

An observational study of Peripheral Vascular Diseases and Peripheral Arterial Disease, run by Ulrich Rother at 1 site in Germany.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The objective of the proposed study is to define independent parameters for the diagnostic assessment of the perfusion situation of the calf muscle based on multispectral optoacoustic tomography (MSOT) in a cross-sectional collective of patients with PAD in Fontaine stage II (intermittent claudication) and a healthy… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Multispectral Optoacoustic Tomography (MSOT)
Type of treatment
Medical device
How many people
100 participants
Where
1 siteGermany
Study dates
20 Jun 2022to 30 Sep 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Patients with * PAD IIa * PAD IIb presenting for consultation during consultation hours of the department of vascular surgery. Healthy volunteers being recruited by notices posted in the clinic with following conditions: * no PAD previously known * no diabetes mellitus previously known * no chronic renal insufficiency previously known * no symptoms of intermittent claudication * ABI with values between 0.9 and 1.4 (screening examination before inclusion in the study) * palpable foot pulses

Who may be able to join

  • Patients with manifest PAD in stage II according to Fontaine or categories 1-3 according to Rutherford or healthy volunteers
  • Adults (>18 years) who are able to give their consent

Who cannot join

  • Patients with PAD stage I, III and IV according to Fontaine or categories 0, 4, 5 and 6 according to Rutherford or healthy volunteers with diabetes mellitus, chronic renal failure, claudication symptoms, abnormal ABI or non-palpable foot pulses
  • Underage persons
  • Lack of written consent
  • Safety concerns of the study physician (person with physical, mental or psychiatric conditions which, by the judgement of the study physician, would compromise the person's safety or the quality of the data, thereby rendering the person an ineligible candidate for the study)

Trial locations and contacts

1 site in 1 country.

Ulrich Rother, PD Dr. med. contact

+4991318542028

ulrich.rother@uk-erlangen.de

Germany1 site, 1 recruiting
  • University of Erlangen-Nuremberg (FAU), Department of Vascular Surgery

    Erlangen, Bavaria, 91054

    Ulrich Rother, Dr. med., +4991318542028, ulrich.rother@uk-erlangen.de

    Werner Lang, Prof. Dr. med., +4991318532968, werner.lang@uk-erlangen.de

    Recruiting

Other trials in Germany

About this study

Official title: Cross-sectional Study of Calf Muscle Perfusion in Patients With Intermittent Claudication by Non-invasive Multispectral Optoacustic Tomography

The objective of the proposed study is to define independent parameters for the diagnostic assessment of the perfusion situation of the calf muscle based on multispectral optoacoustic tomography (MSOT) in a cross-sectional collective of patients with PAD in Fontaine stage II (intermittent claudication) and a healthy control collective (study group 1). The results will be validated using an independent validation group (study group 2).

Read the detailed description

PAD is one of the most common diseases of the elderly. As life expectancy increases, there is a growing need for new treatment concepts and new diagnostic procedures.

Up to now, only the measurement of macrocirculation in the form of CCDS, ABI and measurement of the actual walking distance are available as independent validation measures of revascularization methods (endovascular/open). The S3 guideline for diagnosis, therapy and medical aftercare of PAD published in 2015 by DGA (Deutsche Gesellschaft für Angiologie, German Society for Angiology) recommends such aftercare examinations, especially for patients that underwent vascular surgery. However, for the mentioned validation measures there are some patient groups for which these methods provide only insufficient or unusable results (e.g. diabetes mellitus, terminal renal failure). In these cases, independent verification of the success of the chosen therapy would have to be performed using angiography (digital subtraction angiography, CT angiography or MR angiography). However, this is not routinely performed in the respective patient populations due to the associated risks (including radiation exposure, contrast agent administration, invasiveness).

MSOT provides a new non-invasive diagnostic method that may be able to fill this diagnostic gap. A first study (MSOT_PAD, NCT04641091) confirmed the hypothesis that data collected via MSOT examination of the calf muscle can be used for PAD diagnostics. The derived concentration of oxygenated hemoglobin (HbO2) proved to be the most suitable measurement parameter. A connection could be established between the measured HbO2 concentration and the clinical stage of PAD. Differentiation improved after a standardized exercise of a walking distance of 150 meters, with patients in the stage of intermittent claudication (IC, Fontaine stage II) being more difficult to differentiate in comparison to patients in Fontaine stages III and IV.

The aim of this cross-sectional study is to increase the sensitivity and specificity of the procedure for IC patients by using a more suitable exercise between first and second MSOT measurement, namely repeated heel raises until the occurrence of claudication pain. A subgroup of the IC patients having been included in the study will be asked to undergo the study protocol a second time after interventional/ surgical revascularization. This is to investigate whether and how the improved blood flow situation translates to the measured MSOT parameters.

As additional target variables, the relative, absolute and total walking distance in a 6-minute walk test as well as the PAD-specific quality of life will be recorded with the VASCUQOL-6 questionnaire. A healthy control collective is included as a comparison group.

Being tested
Multispectral Optoacoustic Tomography (MSOT)
Keywords
Peripheral Vascular Diseases, Peripheral Arterial Disease, Peripheral Artery Disease, PAD, Intermittent Claudication, Claudicatio intermittens, Critical Limb Ischaemia, CLI, Critical Limb Threatening Ischemia, CTLI, Color-Coded Duplex Sonography, CCDS, Ankle Brachial Index, ABI, Multispectral Optoacoustic Tomography, MSOT, Heel Raises, 6-minute walk test, 6MWT, Muscle Perfusion
Medical subject headings
Peripheral Vascular Diseases, Peripheral Arterial Disease, Intermittent Claudication, Chronic Limb-Threatening Ischemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Multispectral Optoacoustic Tomography (MSOT)Device

    Non-invasive transcutaneous imaging of subcellular muscle components via infrared and near-infrared laser pulses

Study groups in NCT05373927
Study groupRoleWhat they receive
Study group 1Multispectral Optoacoustic Tomography (MSOT) and B-Mode Ultrasound of the Musculus triceps surae of the affected leg in PAD patients in Fontaine stage II (intermittent claudication) or one leg in healthy volunteers (total 1 site) Physical assessment: Pulse status / Color-Coded Duplex Sonography / Ankle-Brachial Index / 6-minute walk test (6MWT) / Continued heel raises for at least 30s
Receives: Device: Multispectral Optoacoustic Tomography (MSOT)
Study group 2Multispectral Optoacoustic Tomography (MSOT) and B-Mode Ultrasound of the Musculus triceps surae of the affected leg in PAD patients in Fontaine stage II (intermittent claudication) or one leg in healthy volunteers (total 1 site) Physical assessment: Pulse status / Color-Coded Duplex Sonography / Ankle-Brachial Index / 6-minute walk test (6MWT) / Continued heel raises for at least 30s
Receives: Device: Multispectral Optoacoustic Tomography (MSOT)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Optimal diagnostic MSOT thresholds

    Optimal diagnostic threshold for hemoglobin-associated MSOT parameters in calf muscle tissue in patients with intermittent claudication before and after exercise

    Measured: single time point (1 day)

Secondary outcomes (15)
  1. Difference between the corresponding MSOT values before and after exercise

    Difference of the values before and after exercise for hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT in patients with IC

    Measured: single time point (1 day)

  2. Reperfusion profiles for hemoglobin-associated parameters

    Curves of hemoglobin-associated MSOT parameters in the first ten minutes after exercise

    Measured: single time point (1 day)

  3. Correlation of acquired MSOT parameters with the CCDS flow profile and PSV

    Hemoglobin-associated MSOT parameters (units: arbitrary units (a.u.)) in patients with IC correlated with the flow profile and PSV of A. femoralis communis and A. poplitea determined by CCDS

    Measured: single time point (1 day)

  4. Correlation of acquired MSOT parameters with the ABI

    Hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT correlated with the ABI

    Measured: single time point (1 day)

  5. Correlation of acquired MSOT parameters with relative and absolute walking distance

    Hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT correlated with relative (until the first occurrence of pain) and absolute walking distance (until the first stopping due to pain) in the 6-minute walk test (6MWT)

    Measured: single time point (1 day)

  6. Correlation of acquired MSOT parameters with maximum walking distance within 6 minutes

    Hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT correlated with the maximum walking distance during the 6 minutes of the 6-minute walk test

    Measured: single time point (1 day)

  7. Correlation of acquired MSOT parameters with the subjectively perceived maximum walking distance in everyday life

    Hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT correlated with the subjectively perceived maximum walking distance in everyday life

    Measured: single time point (1 day)

  8. Correlation of acquired MSOT parameters with the perceived PAD-specific quality of life (VASCUQOL-6 questionnaire)

    Hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT correlated with the perceived PAD-specific quality of life (VASCUQOL-6 questionnaire)

    Measured: single time point (1 day)

  9. Correlation of the acquired MSOT parameters with the TASC-classification (angiography)

    Hemoglobin-associated parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT in patients with IC correlated with the TASC-classification (angiography) [If angiographic imaging is already available due to routine diagnostics independently from this study.]

    Measured: single time point (1 day)

  10. Subgroup analysis: Difference between the corresponding MSOT values before and after revascularization intervention

    Subgroup analysis: Difference of the MSOT values before and after revascularization intervention for hemoglobin-associated parameters derived by transcutaneous MSOT in patients with IC

    Measured: two time points (2 days)

  11. Subgroup analysis: Reperfusion profiles for hemoglobin-associated parameters after revascularization intervention

    Subgroup analysis: Reperfusion profiles of hemoglobin-associated MSOT parameters (i.e. the curves of hemoglobin-associated MSOT parameters in the first ten minutes after exercise) after revascularization intervention

    Measured: single time point (1 day)

  12. Subgroup analysis: Correlation of acquired MSOT parameters after intervention with the CCDS flow profiles and PSVs after intervention

    Subgroup analysis: hemoglobin-associated MSOT parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT in patients with IC after revascularization intervention correlated with the flow profiles and PSVs of A. femoralis communis and A. poplitea determined by CCDS after revascularization intervention

    Measured: single time point (1 day)

  13. Subgroup analysis: Correlation of acquired MSOT parameters after intervention with the ABI after intervention

    Subgroup analysis: hemoglobin-associated MSOT parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT after revascularization intervention correlated with the ABI measurements after revascularization intervention

    Measured: single time point (1 day)

  14. Subgroup analysis: Correlation of acquired MSOT parameters after intervention with relative (until the first occurrence of pain) and absolute walking distance (until the first stopping due to pain) determined during the 6MWT after intervention

    Subgroup analysis: hemoglobin-associated MSOT parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT after revascularization intervention correlated with relative (until the first occurrence of pain) and absolute walking distance (until the first stopping due to pain) in the 6MWT after revascularization intervention

    Measured: single time point (1 day)

  15. Subgroup analysis: Correlation of acquired MSOT parameters after intervention with maximum walking distance in the 6MWT after intervention

    Subgroup analysis: hemoglobin-associated MSOT parameters (units: arbitrary units (a.u.)) derived by transcutaneous MSOT after revascularization intervention correlated with the maximum walking distance in the 6MWT after revascularization intervention

    Measured: single time point (1 day)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 May 2022
  2. Study start20 Jun 2022 (estimated)
  3. Primary completion30 Sep 2022 (estimated)
  4. Study completion30 Sep 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05373927
Sponsor's protocol ID
MSOT_IC
Acronym
MSOT_IC
Status last verified
May 2022
First submitted
9 May 2022
Last updated
27 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Lawall H, Diehm C, Hoffmann U, Reinecke H. [Update PAVK: Epidemiology, comorbidity and prognosis of peripheral arterial obstructive disease]. Dtsch Med Wochenschr. 2015 Dec;140(24):1798-802. doi: 10.1055/s-0041-107064. Epub 2015 Dec 1. German.

    PubMed 26625226
  • Lawall H, Huppert P, Espinola-Klein C, Zemmrich CS, Ruemenapf G. German guideline on the diagnosis and treatment of peripheral artery disease - a comprehensive update 2016. Vasa. 2017 Mar;46(2):79-86. doi: 10.1024/0301-1526/a000603. Epub 2017 Jan 27.

    PubMed 28128018
  • Alpert JS, Larsen OA, Lassen NA. Exercise and intermittent claudication. Blood flow in the calf muscle during walking studied by the xenon-133 clearance method. Circulation. 1969 Mar;39(3):353-9. doi: 10.1161/01.cir.39.3.353. No abstract available.

    PubMed 4885945
  • Karlas A, Masthoff M, Kallmayer M, Helfen A, Bariotakis M, Fasoula NA, Schafers M, Seidensticker M, Eckstein HH, Ntziachristos V, Wildgruber M. Multispectral optoacoustic tomography of peripheral arterial disease based on muscle hemoglobin gradients-a pilot clinical study. Ann Transl Med. 2021 Jan;9(1):36. doi: 10.21037/atm-20-3321.

    PubMed 33553329
  • Larsen ASF, Reiersen AT, Jacobsen MB, Klow NE, Nordanstig J, Morgan M, Wesche J. Validation of the Vascular quality of life questionnaire - 6 for clinical use in patients with lower limb peripheral arterial disease. Health Qual Life Outcomes. 2017 Sep 22;15(1):184. doi: 10.1186/s12955-017-0760-3.

    PubMed 28938901

Questions about this trial

What is this clinical trial studying?

An observational study of Peripheral Vascular Diseases and Peripheral Arterial Disease, run by Ulrich Rother at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Ulrich Rother, PD Dr. med. (+4991318542028, ulrich.rother@uk-erlangen.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Optimal diagnostic MSOT thresholds (time frame: single time point (1 day)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05373927, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 May 2022.

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MSOT_IC Clinical Trial NCT05373927 | AzTrials